If you are graduating, Congratulations! Please complete and submit this form. Name First (first) Middle Initial (middle initial) Last (last) Address Address? (number and street) City/Town (city) State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming (state) ZIP/Postal Code (zip code) Student ID # Email Phone The Governor’s Cup Scholarship Program rules require recipients to annually file a statement of intent to continue as a full-time undergraduate student. Please complete this questionnaire and return it to the program manager no later than January 30th. I intend to enroll Fall 2020 Institution Name Institution Address City/Town (city) State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming (state) ZIP/Postal Code (zip code) I do not intend to enroll in 2020 – 2021 due to one of the following: Graduation End of Eligibility Requesting Leave of Absence or Suspension (must submit letter explaining by January 30th due date) Other (please explain) Selection Criteria Current Grade Point Average Current Grade Point Average Cumulative Grade Point Average Cumulative Grade Point Average Grade Level in Fall 2020 Senior Junior Sophomore Freshman Please include a paragraph below highlighting your college experience and accomplishments. We will use these updates when promoting our scholarship program. Academic Highlight Share This Page Facebook Twitter linkedin email
